On May 22, more than 400 American College of Radiology (ACR) members will speak with their elected federal representatives to discuss four legislative priorities as part of Capitol Hill Advocacy Day at the 2019 ACR Annual Meeting.
Below are summaries of the ACR’s stance on the four legislative issues:
Limiting surprise medical bills
“Issues surrounding beneficiaries being burdened with high out-of-pocket costs and inadequate provider networks present real issues for patients in need of life saving diagnostic imaging services,” according to an ACR position statement. “The problem of unanticipated out-of-network bills is complex, and requires a balanced approach to resolve.”
A key problem, according to the ACR, is that health insurance plans are leaning on a narrow network of providers to control costs, and as a result even patients who make sure they receive in-network care are still burdened by surprise out-of-network bills because they were unaware that out-of-network providers were involved in some point of their care process.
The ACR urges lawmakers to put in place protections for patients, hold insurers accountable, avoid benchmarked payments and look at state’s like New York for out-of-network billing solutions.
Protect the Patient Access for Lifesaving Screening (PALS) Act
The United Services Preventative Task Force (USPSTF) breast cancer screening recommendations favor biennial screening mammography at age 50, going against the recommendations of many agencies— including the ACR— that suggest screening start at age 40.
Currently, there is a moratorium on recognition of the USPSTF breast cancer screening guideline, set to expire on December 31, 2020. If these recommendations are recognized, individual and group insurance plans would no longer be required to cover annual mammography with no cost sharing for women ages 40 to 49.
“The ACR urges Congress to enact bipartisan legislation extending the current moratorium. Failure to do so could result in thousands of additional, and unnecessary, breast cancer deaths, and thousands more women enduring extensive surgery, mastectomies, and chemotherapy for advanced cancers which could be avoided with annual screening beginning at age 40 for women of average risk,” according to a position statement from the ACR.
Resident Education Deferred Interest (REDI) Act
The average radiology resident who has $300,000 in medical school loans will pay more than $75,000 in additional interest during their four years in residency.
Medical student debt has only increased since 1992, the ACR noted, and it may be a significant factor in the projected physician shortage predicted by the Association of American Medical Colleges.
“At a time when the United States needs to provide additional incentives to avoid a physician shortfall in the near future, halting the accrual of interest during residency through the enactment of H.R. 1554 (the REDI Act) will relieve some of the financial burdens of pursuing a career in medicine/dentistry by providing significant savings for young physicians,” read an ACR statement.
Medicare Access to Radiology Care Act (MARCA)
The demand for timely medical imaging is rising and simultaneously Medicare is looking to create value-based and efficient solutions to improve patient outcomes, particularly in radiology.
“While Radiologist Assistants (RAs) are newly recognized under Medicare to perform diagnostic imaging services under direct supervision, the radiology practices that employ them are currently unable to submit claims to Medicare for procedures or non-diagnostic services RAs perform in hospitals, where they normally work,” according to the ACR. “This new MARCA bill language allows RAs to be fully utilized in radiology practices to provide high quality, efficient, and cost-effective care to patients.”
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.